Monday, January 6, 2014

The British Medical Journal recently contributed an important piece of literature to answer an age-old nurses station question: "Who the hell ate the chocolate?"

The article's introduction states "Subjectively, we noted that chocolate boxes emptied quickly and that
determining which healthcare professionals ate the most chocolates was a
common source of workplace conflict. Literature on chocolate
consumption by healthcare workers in a hospital setting is lacking."

To study this critical issue, the authors placed 2 boxes of chocolates (1 each of Cadbury Roses and Nestlé Quality Street) at the nurses stations of 4 floors in 3 separate hospitals (258 pieces of chocolate in total). They were covertly observed and critical data collected.

They found that:

1. When a box of chocolates is placed out on the ward, there's an average delay of 12 minutes before someone opens it. The Cadbury box was more likely to be opened first.

2. The half-life of a box (time until 50% of chocolates had been eaten) was 99 minutes. Chocolates that were still present at the end of the 4-hour observation period were deemed "lost to follow-up." Overall, 74% of chocolates were eaten during the observation time.

3. Chocolates are consumed in a non-linear fashion: initially there's a flurry of consumption when a box is opened
("Oooh! Chocolates!") which gradually tapers off ("No, I've had enough")
with increasing intervals between pieces being eaten ("I'm trying to
diet.").

4. Cadbury chocolates were consumed faster than Nestlé.

5. A statistical breakdown of "WHO ATE THE CHOCOLATE?!!!" revealed the following:

"Medical students who reached for one were shot."

Personally, I believe further research is needed, and propose the following:

1. A similar study comparing dark vs. milk chocolate.

2. A study powered to prove/disprove that ones with nougat are the last to be eaten.

3. Comparison of M&M's (plain vs. peanut vs. pretzel vs. dark vs. peanut butter). For example, in my office the half-life of a 1 lbs. bag of the peanut-butter ones is about 38 seconds, while up front the plain ones go faster.

4. Getting a staff breakdown to figure out who's pushing in the bottom to see what filling it is. And when you find out, beating them senseless.

More research of this type is necessary, and so, when you hit up a doctor to bring in some chocolates, remind them you're only doing so for science.

Lastly, I loved the "authors' conflict of interest disclosure" from the article:

"Competing interests: All authors have completed the ICMJE uniform disclosure form and declare: no
support from any organisation for the submitted work; no financial
relationships with any organisations that might have an interest in the
submitted work in the previous three years. Other non-financial relevant
interests: PRG is particularly sentimental about, and incredibly fond
of, Lindt Lindor white chocolate truffles; DJM advocates abstinence as
the only effective way to avoid chocolate over-consumption; PLRN is
influenced by the intoxicating smells emanating from the Cadbury’s
chocolate factory at Bournville near his home; FDA supports her native
Ghana’s cocoa exports by eating a single Heroes chocolate (Cadbury)
every night; HEC declares an interest in polishing off leftover Bounty
chocolates (Mars); RDM’s Germanic background means that he is
hard-wired, like his brethren, to love all milk chocolate; and CAM
reports a preference for Milkybar buttons (Nestlé)."

This article was in the Christmas.issue that included several intentionally humorous articles. There was also an article on James bond' drinking habits and if men named brady had a higher incidence of bradycardia.

I suspect that the difference between the Cadbury and Nestle consumption has to do with the kerfuffle some decades ago when Nestle was caught adding less protein to its infant formula, the fact that Nestle is at odds (or perhaps merely a direct competitor of Hershey which is an American favorite), or that the English Cadbury was recently acquired by an American company, so that makes 'them' more politically correct than Nestle. On the other hand, I'd like to participate in a blinded RCT with a sample of five different types of chocolate on five different occasions, at least, for a really complete set of results.

Welcome to my whining!

This blog is entirely for entertainment purposes. All posts about patients may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate.

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